In May 2014, the Royal Australian College of Physicians submitted a report to the Human Rights Commission Inquiry into Children in Immigration Detention. As health professionals in Australia, we have a responsibility to protect the interests of children in our country. It is clear that the basic rights of children are not being upheld when it comes to immigration detention.
Here, we summarise the key issues in the RACP report. The full report can be read here.
People fleeing their home countries arrive in Australia to seek asylum. They are put in detention centres while their asylum application is being processed.
Australia is a signatory to the Convention on the Rights of the Child which states that “no child shall be deprived of his or her liberty unlawfully or arbitrarily”. However, Australia is the only country which continues with the use of remote, indefinite, mandatory detention for children and their families.
The most recent government statistics, from March 2014 indicate that there are 1074 children currently in closed detention. 590 of these are on the Australian mainland, 205 on Christmas Island, and 179 on Nauru.
The average length of stay in immigration detention is 275 days.
The giant problem with keeping children in immigration detention for such long periods are that their basic rights are not being met. This includes: education; physical and mental health; recreation; family relationships – privacy and security; hygiene and nutrition.
It seems obvious to say, but the mental health of children is at huge risk due to being kept in detention for lengthy periods of time – the longer the detention, the greater the impact on mental health (Steel et al, 2006). They have no certainty about their future or what will happen to their family. There are some counselling services in detention facilities but the level of this and the experience of those delivering it is variable. This is a reactive service and does not best serve the needs of the child.
From a medical point of view there is inadequate access to paediatric healthcare reviews, along with no services for children with disability or developmental concerns.
Detention in a facility does not allow for normal functioning of family life. Simple things such as eating together, or cooking together in the family unit can not happen due to families living in close proximity to others. There is no time or space for privacy and developing normal family relationships.
And many families are not even kept together, with separation being common resulting in the loss of the child’s support network increasing distress.
Living as though in a prison does not foster secure development for children. There is no freedom of movement, they have identification numbers, and are surrounded by wire fences and security staff.
The facilities, particularly in off-shore detention, are often crowded and unsanitary. Toilet facilities are inadequate and unclean and respiratory, gastro, and skin conditions related to crowded living are rife. The actual housing conditions are temporary and the environment is unsafe (rocky areas, spaces underneath buildings etc).
Children are forced to eat institutional meals leading to inadequate nutrition and lack of exercise, often resulting in older children being overweight. And for younger children there is no flexibility with infant meals resulting in toddlers failing to thrive and with nutritional deficiencies.
Schooling and education is seriously lacking in detention facilities. For those on Christmas Island, most only receive 2-4 weeks of schooling over a 6-8 month period. For other locations, access varies from place to place.
And furthermore, children don’t have access to play and leisure facilities. There are no safe environments to allow children to play and enjoy themselves (de Costa and Adams, 2014).
If that isn’t enough to persuade you that something needs to be done, I don’t know what is.
The Australian Medical Association have also supported an end to the detention of children but this has not been without controversy (Hambleton, 2011). Some people feel strongly that these professional bodies should be keeping out of politics and instead should focus on medicine. I could not be more pleased to see the RACP and the AMA taking such a firm stance on a political, medical, and humanitarian issue, and we should be supporting them fully.
Children should have access to schooling, a good diet, paediatric healthcare, leisure activities, and be able to live in a hygienic environment. But perhaps more importantly they should be able to spend time building quality relationships with their family and be able to live in a free environment without fences, security watchmen, and the stress of imprisonment.
The current situation is not acceptable. Children do not belong in detention centres.
Adams E. de Costa C 2014. Do no harm, MJA InSight, https://www.mja.com.au/insight/2014/12/emma-adams-caroline-de-costa-do-no-harm (accessed 25 June 2014).
Convention on the Right of the Child, UNHR, http://www.ohchr.org/EN/ProfessionalInterest/Pages/CRC.aspx (accessed on 25 June 2014).
Hambleton S, 2011. Standing up for refugees, MJA InSight, https://www.mja.com.au/insight/2011/32/steve-hambleton-standing-refugees (accessed 25 June 2014).
National inquiry into children in immigration detention, 2004. Australian Human Rights Commision, https://www.humanrights.gov.au/national-inquiry-children-immigration-detention (accessed on 25 June 2014).
Steel Z, Silove D, Brooks R, Momartin S, Alzuhairi B, & Susljik I 2006. Impact of immigration
detention and temporary protection on the mental health of refugees British Journal of Psychiatry
188(4):58-64 http://bjp.rcpsych.org/content/188/1/58.full.pdf+html (accessed 25 June 2014).